Decision Report 201402387

Summary

Miss C attended an emergency dental appointment, as she was concerned about a large lump in her mouth that had become extremely painful and caused her face to swell. The swelling had been developing for a week, and had worsened despite receiving antibiotics and starting root canal treatment with her regular dentist.

The dentist at the emergency appointment immediately referred Miss C to hospital, and gave her a letter of referral to take with her. Miss C asked where exactly she should go, and the dentist told her to go to A&E, as they would transfer her to the right unit. However, when she got to A&E, staff told Miss C she was given the wrong advice and the dentist should have phoned the maxillofacial unit (a unit specialising in the diagnosis and treatment of diseases affecting the mouth, jaws, face and neck) and sent her there directly. At the unit, Miss C had an infected tooth removed and the abscess in her mouth was drained. While she was there, hospital staff called the practice to advise them of the correct referral process for that unit.

Miss C complained about the care and treatment she had received. In particular, Miss C was concerned that the dentist had not taken an x-ray, or tried to drain the abscess or remove the tooth themselves. She said that staff at the hospital told her this was a simple procedure, and the dentist could have phoned the hospital and received advice over the phone about this. The dentist explained that in Miss C's condition he thought it was appropriate to refer her for hospital treatment immediately. He apologised for not knowing the correct referral process for the unit, and explained that dentists at the practice had now been made aware of this. Miss C was not satisfied with the dentist's response, and brought her complaint to our office.

After taking independent dental advice, we did not uphold Miss C's complaint. We found that the dentist had acted correctly in referring her immediately to hospital, and it would not have been appropriate for the dentist to take an x-ray or attempt treatment himself (even with advice from the hospital). Although the dentist should ideally have referred Miss C directly to the specialist unit, we found that the important thing was for her to be transferred to hospital as soon as possible, so it was not unreasonable to tell her to go to A&E.